Friday, May 15, 2015

Never tell a runner not to run!

According to Whitfield Reaves,"you can never tell a runner not to run."    This week a female runner came in with chronic achilles pain.  Both achilles were very tender and painful to the touch.  The tissue was inflamed and nodulated.  Knowing that she would keep running, my goal was to support her body to repair the damaged tissue by reducing the inflammation while increasing the blood and "qi" flow.
Achilles tendinopathy affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response. The source of pain in tendinopathy could be related to the neurovascular ingrowth seen in the tendon's response to injury. 

The achilles tendon tends to get lesions on the anterior portion of the tendon, where there is not much blood flow.  Correctly place acupuncture needles can directly affect this portion of the tendon.  Electrical stimulation of those needles directs the body to clean up the injured tissue.  Tight or knotted calf muscles can also contribute to chronic achilles problems.   If the calf is involved, adding acupuncture needles in the motor points of the gastrocnemius and soleus group.  We call this type of needling anatomical acupuncture which we use in combination with Chinese Medicine's Channel Theory. The achilles tendon is on the Tai Yang channel.   In Chinese medicine the tendons are the tissue of the "liver" system which corresponds to "wood." Tendinopathies are a problem with "wood."  I also used the wood points on the Tai Yang channel to support the treatment.

My treatment plan was treatments bi-weekly for three weeks, with the understanding that she would not stop running during the course of the treatment. My treatments included electroacupuncture, motor point acupuncture, gua sha therapy and tui na massage. After the first treatment, she reported no pain for the remainder of the day.  This lasted for almost two days.  After the second treatment, she was able to run with out pain. While it is exciting to have results, this was a dangerous time.  The danger with acupuncture treatment is that it often reduces the experience of pain.  Pain is an important message from the body.  It lets us know when there is an injury that needs care and support. If we don't get the message that there is an injury, but the injury is still there, it can be tempting to overuse the body.

Wednesday, May 13, 2015

Acupuncture Alternative for de Quervains

I developed de Quervain's after my son was born, it is actually quite common with new mothers.  It can also show up with gamers, guitar players, texting and other repetitive hand motions.  Patients often report that the pain is agonizing. Not only is the pain intense, but there can also be a loss of functionality.  This loss of function with a new baby is what inspired me to look for alternative treatments.  Western medicine only offers treatment options of  NSAIDS, steroid injections and/or surgery.  These options didn't work for my long term systemic health goals and my immediate need for functional hands, as a new mother.   For patients looking for options, we treat this condition with electro-acupuncture, dietary therapy  and herbal medicine. Everyone responds differently to treatment, and Chinese medicine does not have a one-size-fits-all approach.  I used a combination of electro-acupuncture, dietary therapy and herbal medicine.
  de Quervains Disease

Repetitive movements stressing the tendon combined with runaway inflammation can create the perfect storm. De Quervain's tenosynovitis or disease is an inflammatory condition which can present with wrist and thumb pain.  It often presents with swelling or crepidus (crunchiness). It is painful with movement of the thumb.

The diagnosis is a very simple test.  It can be painful. This simple video shows how to test.

Saturday, May 2, 2015

Enhance Athletic Performance with Acupuncture

Here is a great article by my mentor, Whitfield Reaves, about acupuncture treatments to enhance athletic performance for lower extremity athletes (ie. runners)  and upper extremity athletes (ie. baseball pitchers, swimmers etc.)

Acupuncture and the Athlete

Jan 19, 2012
Written by Whitfield Reaves, Licensed Acupuncturist
Acupuncture has been practiced for centuries. The early stories of acupuncture chronicle Chinese martial artists who used needles to relieve their pain after being injured. Warriors and soldiers have historically received acupuncture to improve their stamina and endurance. And in the modern era, many athletes in professional sports and the Olympics extol the virtues of being treated by their acupuncturist.

Low back pain and sacroiliac joint dysfunction in young athletes

Stubborn low back pain in Chinese Medicine if often treated as a "Kidney deficiency."  In young athletes with low back pain, it doesn't make sense to diagnosis kidney deficiency, which is associated with aging.  If there is pain with weight bearing, the sacroiliac joint (SIJ) might be the cause of the pain.  Low back pain is often associated with sports involving repetitive extension, flexion, and rotation, such as gymnastics, dance, soccer and rugby. The SI joint is an area that is rich in fascia and ligaments, therefore it responds well to acupuncture with electrical stimulation.The SIJ is a weight bearing joint, so pain with weight bearing with clue the practitioner to check the SIJ. 

I have found that the sports medicine acupuncture techniques as taught in the Sports Medicine Apprenticeship Program: Treatment of the Low Back, Hip and Pelvis have an amazing effect on chronic low back pain due to sacroiliac joint dysfunction.

Using specific sports medicine techniques more directly addresses this type of stubborn, chronic dull achey low back pain, especially when combined with Chinese Medicine's channel theory.  

"Sacroiliac Joint

The sacroiliac (SI) joint disperses the forces between the trunk and the lower extremities. This joint can be a source of pain in young athletes because of excessive or reduced motion within the SI joint. Pathology of the lumbar spine can alter the mechanics of the lumbar spine, resulting in stress to the SI joints.25 Inflammation of the SI joint can also result in SI joint pain. SI joint inflammation can occur from infection, such as Reiter syndrome, as well as from seronegative spondyloarthropathies, such as Crohn disease, psoriatic arthritis, and juvenile ankylosing spondylitis. Another cause of SI joint pain is a stress fracture of the sacrum.25
Athletes with SI joint pain present with extension pain that is insidious in onset.11,25 On examination, pain is localized to the lumbar or buttock region with extension of the spine. They may have poor pelvic stability on Trendelenburg testing, as well as a positive FABER test (Figure 7). Palpation elicits tenderness over the affected SI joint.2,11,25"" 

Friday, May 1, 2015

Broken bones and bone broth soup

Homemade bone broth is one of  the most common dietary recommendations for patients recovering from bone fractures.  It is also great for patients with osteoporosis,  or for those with tendon and cartilage issues.  A daily dose of bone broth can work wonders.  It is so easy to prepare. You may have seen chicken feet at your local Chinese restaurant and wondered, “why?”

Patients are looking for safe options to support their bones and tendons. Especially with the negative press about calcium supplementation’s increased risks of dementia and cardiovascular events.
Dietary therapy is an incredibly simple and useful tool in Chinese Medicine. Nutrient rich broth allows for

Rugby World Cup Sevens 2018 in SF will offer Acupuncture!

So excited to be a part of the Rugby World Cup Sevens 2018 at AT&T Park in San Francisco.  I will provide sports acupuncture therapy...